Z. Shamsi et I. Hindmarch, Sedation and antihistamines: A review of inter-drug differences using proportional impairment ratios, HUM PSYCHOP, 15, 2000, pp. S3-S30
Citations number
173
Categorie Soggetti
Neurosciences & Behavoir
Journal title
HUMAN PSYCHOPHARMACOLOGY-CLINICAL AND EXPERIMENTAL
The use of antihistamines (AHs) has until recently been associated with a n
umber of undesirable side effects, the most troublesome of which is sedatio
n. There are two aspects to sedation. The first, an objectively determined
measure based on the results of psychometric tests from controlled trials,
and the second, the subject's response to the administration of a drug. Sin
ce AHs are largely used in ambulant patients, a complete evaluation of seda
tion should be performed through standardised objective and subjective test
s, shown to be sensitive to the central effects of AHs.
An extensive review of the literature identified 76 studies of H-1 receptor
antagonists in healthy volunteers, in which assessment of sedation was the
primary objective. Results from studies published in peer-reviewed journal
s which employed a placebo condition as well as a positive internal control
using a crossover design were analysed to determine the extent to which a
particular antihistamine produced impairments on a battery of psychometric
tests. The impairment index for each antihistamine was calculated and subse
quently compared with the impairment index obtained for all other AHs.
The calculation of this proportional impairment ratio enabled the sedative
potential of an individual antihistamine to be identified relative to all o
ther AHs and thus allowed the ranking of AHs with respect to their ability
to cause impairments of cognitive and psychomotor function.
Findings from this review clearly demonstrate that there are distinct class
es of AHs with respect to their ability to impair cognitive function and ps
ychomotor performance. Copyright (C) 2000 John Wiley & Sons, Ltd.